Effect of cognitive behavioral therapy on pain, knee function, and psychological status in patients after primary total knee arthroplasty: a systematic review and meta-analysis

• Published in: BMC musculoskeletal disorders Vol. 25; no. 1; p. 280
• Main Authors: Liu, Kun, Liu, Yuandong, Ma, Xukai, Fu, Donglin, Fan, Zongqing
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 11-04-2024; BioMed Central; BMC
• Subjects: Arthritis; Arthroplasty (knee); Behavior modification; Care and treatment; Catastrophizing; Clinical trials; Cognitive ability; Cognitive behavioral therapy; Cognitive therapy; Function; Hypothesis testing; Joint replacement surgery; Kinesiophobia; Knee; Meta-analysis; Osteoarthritis; Pain; Pain, Postoperative; Patient outcomes; Patients; Software; Statistical analysis; Systematic review; Total knee arthroplasty; China; Kinesiophobia; Function; Total knee arthroplasty; Pain; Catastrophizing; Cognitive behavioral therapy; Meta-analysis
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-024-07413-1

The clinical efficacy of cognitive behavioral therapy (CBT) after Total knee arthroplasty (TKA) is still controversial, and the purpose of this meta-analysis was to evaluate the effect of CBT on pain, knee function, and psychological status of patients after TKA.
We systematically searched electronic databases such as CNKI, CBM, VIP, PubMed, Cochrane Library, and EMBASE for randomized controlled studies up to February 30, 2023. Screening against inclusion criteria to select valid studies and extract data. The quality of included studies was evaluated by the Cochrane Collaboration risk-of-bias 2 (RoB 2) tool for randomized trials. Statistical analysis of the data from this study was carried out using Stata 15.1 software.
Finally, our meta-analysis incorporated seven randomized controlled studies of high quality, including 608 patients. The findings of the meta-analysis demonstrated a noteworthy decrease in kinesiophobia levels during the early postoperative phase in the CBT group as compared to the usual care group (WMD = -6.35, 95% CI: -7.98 to -4.72, Z = 7.64, P < 0.001). However, no statistically significant difference between the CBT and usual care groups in terms of postoperative pain as well as knee function.
CBT may effectively reduce the level of kinesiophobia in the short term after TKA, but did not significantly relieve knee pain or improve knee function.